

<?php 
$CI =& get_instance();

$CI->load->database();
$CI->load->library("front/header_lib");

$page_title =  "Make a payment";

$query_pages = $CI->db->get_where('bur_staticpages',array('staticpage_link'=>'make_payment'));

foreach($query_pages->result() as $row_vals)
{
     $title = $row_vals->staticpage_title;
	$metakey_page = $row_vals->staticpage_metakey;
    $metadesc_page = $row_vals->staticpage_metadesc;  
}

$datas = array();

$CI->header_lib->display_header_element(array("script"=>array("jquery-1.4.2","jquery.validate"),"page_title"=>$title,"metakey_page"=>$metakey_page,"metadesc_page"=>$metadesc_page));
$CI->header_lib->display_header($datas);


?>
<!--body content starts-->

<div id="container_wrapper">
	<div id="body_container">
    	<div class="left_part">
        	<a href="<?php echo site_url();?>"><img class="sub_smallLogo" src="images/small_log.jpg" height="201" width="262" alt="Mykprisguide US" /></a>
            <div class="div04">
            <p class="normal_text">Request a quote for printing instantly. Simply input the details and submit the form to us. We will get back to you within 24 hours with your quote.</p>
            <a class="readmore">our printing specialities &gt;&gt;</a>
            </div>
             <div class="request_quote">
            <ul>
            	<li class="plusBull"><a class="white_link" href="<?php echo site_url('digital-print')?>">short run digital print</a></li>
                <li class="plusBull"><a class="white_link" href="<?php echo site_url('litho-print')?>">traditional litho print</a></li>
                <li class="plusBull"><a class="white_link" href="http://www.24hourcards.co.za" target="_blank">business cards</a></li>
                <li class="plusBull"><a class="white_link" href="http://www.24hourphotobooks.co.za" target="_blank">photobooks</a></li>
            </ul>
            </div>
        </div>
    	
        <div class="right_part">
            <?php
            $attributes =  array('id'=>'paymentform', 'name' => 'paymentform');
            echo form_open("make-a-payment",$attributes);?>
            <div class="requrest_quote">
            <ul>
            	<li>
                <div class="list_div01">&nbsp;</div>
                <div class="list_div02">
                	<h1 class="heading01">make a payment </h1>
                    <p class="redTxt">Make a payment online using our secure payment gateway. Simple fill in the detail below and submit.</p>
                </div>
                <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">your name</div>
                    <div class="list_div02">
                    	<input name="name" id="name"  type="text" value="<?php echo $name;?>" />
                		<?php echo form_error('name'); ?>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">company</div>
                    <div class="list_div02">
                     	<input type="text" name="company" id="company" value="<?php echo $company;?>" />
               			 <?php echo form_error('company'); ?>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">telephone</div>
                    <div class="list_div02">
                    	 <input name="telephone" id="telephone" value="<?php echo $telephone;?>" type="text" />
                		<?php echo form_error('telephone'); ?>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">e-mail</div>
                    <div class="list_div02">
                    	<input type="text" name="email" id="email" value="<?php echo $email;?>" />
               			<?php echo form_error('email'); ?>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01" style="width:129px; margin:0; text-align:left;">payment for</div>
                    <div class="list_div02">
                    	<input type="text" name="payment_for" id="payment_for" value="<?php echo $payment_for;?>" />
               			<?php echo form_error('payment_for'); ?>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">country</div>
                    <div class="list_div02">
                    	<select name="country" id="country">
		                <?php foreach($countrydropdown as $dropvals){?>
        	            <option value="<?php echo $dropvals->country_name?>"><?php echo $dropvals->country_name?></option>
            		    <?php }?>
                		
                	</select>
                    <?php //echo form_error('country'); ?>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">Amount</div>
                    <div class="list_div02">
                    	<input type="text" name="payment_amount" id="payment_amount" value="<?php echo $payment_amount;?>" />
                		<?php echo form_error('payment_amount'); ?>
                        <p>Payment amount (In South African Rands)</p>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">Payment Method</div>
                    <div class="list_div02">
                    	<div class="payment_box_style">
                <ul>
                	<li>
                    	<div style="width:20px; float:left;"><input name="payment_type" id="payment_creditcard" type="radio" checked="checked" value="1" /></div>
                        <div style="display:block; float:left;">Credit Card:</div>
                        <img style="display:inline-block; float:left; margin-left:10px;" src="<?php echo site_url()?>images/credit_card.jpg" height="26" width="78" />
                        <div class="clear"></div>
                    </li>
                    <li>
                    	<div style="width:20px; float:left;"><input value="2" name="payment_type" id="payment_banktransfer" type="radio" /></div>
                        <div style="display:block; float:left;">Pay via internet bank transfer<br />
                        <img style="display:block; margin-top:5px" src="<?php echo site_url()?>images/bank_icon.png" height="76" width="305" alt="" /></div>
                        <div class="clear"></div>
                    </li>
                </ul>
                </div>
                    </div>
                    <div class="clear"></div>
                </li>
                <li>
                	<div class="list_div01">Security</div>
                    <div class="list_div02">
                  		 <?php echo $recaptcha;?>
                         <?php echo form_error('recaptcha_response_field'); ?>
                    </div>
                    <div class="clear"></div>
                </li>
                <div class="height10_10"></div>
                <li>
                	<div class="list_div01">&nbsp;</div>
                    <div class="list_div02">
                    	<input type="image" value="" name="submit" id="submit" src="images/submit_btn.jpg" height="57" width="378" style="border:1px solid #194C75" />
                    </div>
                    <div class="clear"></div>
                </li>
                </ul>
                </div>
            <?php echo form_close();?>
            
        </div>
        <div class="clear"></div>    
    </div>
</div>

<!--body content ends-->
<?php
$CI->load->library("front/footer_lib");
$CI->footer_lib->display_footer();
?>
<script type="text/javascript">
$(document).ready(function(){
    $('#paymentform').validate({
        
    });
    
});
</script>
<?php
$CI->footer_lib->display_footer_element();

?>